Councilors Raise Concerns Over Medicaid Contract

The Executive Council has delayed a vote on the controversial new $2.2 billion dollar managed Medicaid contract.

That's welcome news for many New Hampshire healthcare providers who are concerned about the deal.

Executive Councilors say they too want to know whether managed care will compromise services for the some 130,000 Medicaid recipients in the state.

Dan Gorenstein: Executive Councilor Ray Burton says he’s got thousands of reasons why he wants to slow down signing off on this contract.

BURTON: “There are 13,600 clients in developmental disabilities and mental health. Spending at the present time spending $92 million dollars in Council District 1.”

GORENSTEIN: The council has voted to take a second look at the proposed deal in three weeks.

In the meantime, Burton plans to review the contract between the Department of Health and Human Services and the three managed care companies.

BURTION: “I’m going to make sure the money is going to flow to the proper providers so they are not left hanging. I want to make sure no offices are going to close. I want to make sure people are going to get those services more efficiently, that’s what managed care is all about.”

GORENSTEIN: The Council has also scheduled a public meeting with HHS and managed care company officials April 13thin Concord.

Burton understands he’s not the only one out there with questions.

He says he’s already hearing an earful – in a good way – from his constituents.

GORENSTEIN: Healthcare providers will certainly be picking up the phone over the coming weeks.

Jay Couture, president of New Hampshire Community Behavioral Health Association says she has simple, basic questions she wants answered before any deal is signed.

COUTURE: “We are absolutely in an under-resourced system. People are not getting their needs met. People are being left in emergency rooms for days on end at times, waiting for a bed at New Hampshire Hospital. And I don’t understand how with fewer resources in the system, people are going to get the care they need faster and more effectively.”

GORENSTEIN:While Couture is talking about people with mental illness, many providers to the estimated 130,000 Medicaid patients have a similar question.

‘How will these managed care companies do more with less?’

Providers and patients worried.

HHS Commissioner Nick Toumpas understands that, and says he’ll try to address as much of that concern as he can.

He says he’s even going to post specific responses on the department’s website.

But the commissioner says just because the Executive Council is delaying the vote on the contract doesn’t mean he’s going to restructure the contract.

He says councilors have three options.

TOUMPAS: “The actual terms and conditions of the contract, I can’t change those. There’s no way. Basically the action is, one of three actions, pass it, reject it, or table it.”

GORENSTEIN: Until earlier this week, the department planned to launch managed Medicaid July 1st.

Toumpas says realistically, the new launch will be sometime between September and the end of the calendar year.

A slower start could make it harder for HHS to realize the $16 million dollars in savings earmarked in the budget.

The commissioner says if they can’t get the savings from Medicaid, it will have to come from some other program from the Department.